Study 1- Identifying the neural and hormonal mechanisms underlying changes in pain during pubertal maturation

As we grow and mature, our body undergoes extensive development. Some stages, such as puberty, involve significant changes in sex hormone levels, brain structure, and neural function, which can impact pain sensitivity and nociceptive processing, and lead to the development of chronic pain.

During pubertal maturation, we see an increase in the prevalence of chronic pain syndromes, such as headache/migraine, abdominal pain, back pain, fibromyalgia. However, for some chronic pain syndromes, this increased prevalence is observed only in females – and even in healthy females, we can observe higher pain sensitivity to experimental pain during and after puberty. We do not yet know what makes females more sensitive to pain during puberty. This study involves assessments of experimental pain, sex hormone levels, psychological factors, and brain structure and resting-state functional connectivity using MRI/fMRI.

If you would like to participate in the study or for more information about the study, please contact the lab at painlab@wustl.edu.

This study is funded by the International Association for the Study of Pain (IASP).


Study 2- Predicting migraine diagnosis in adolescents

Why do some individuals develop chronic pain? Can we predict who will develop chronic pain?

During adolescence, we see a significant increase in the prevalence of headache and migraine diagnosis. Two risk factors for this increase are:

  1. Sex: women have a higher prevalence of migraine diagnosis with a ratio of 3:1 (women: men),
  2. Family history: 20-62% of individuals with a first-degree relative with migraine will be diagnosed with migraine at some point.

Interestingly, we have shown that healthy adolescents with a first-degree relative have higher pain responses to experimental pain (Nahman-Averbuch, 2019). We have yet to determine whether these changes can be used to predict who will be diagnosed with migraine. 

This study utilizes experimental pain, psychological factors and brain structure and function measures to develop a predictive model for migraine diagnosis in adolescents at a higher risk of being diagnosed with migraine.

If you would like to participate in the study or for more information about the study, please contact the lab at painlab@wustl.edu.

This study is funded by a National Institutes of Health (NIH) R01 grant.


Study 3- Sex hormone levels, postoperative pain and opioid use

A significant number of patients that undergo surgery will experience moderate to severe acute postoperative pain, and some will develop persistent, chronic pain. Studies in animals suggest a role for sex hormones on pain and opioid analgesia. However, it is still unclear if sex hormone effects on post-operative pain and opioid use in patients. This study aims to identify the relationships between sex hormone levels and postoperative pain and opioid use.

This study is funded by the Washington University School of Medicine, Department of Anesthesiology.

Study 4 – The mechanisms underlying endometriosis pain

Endometriosis is a highly prevalent and disabling disorder with significant variability in pain severity. Pain is difficult to manage potentially due to elevated estrogen levels from lesion hormone profiles, the hormonal medication used to manage endometriosis, and individual sensitivity to pain. Laparoscopic surgery is a tool for both diagnosis and treatment of endometriosis, but we want to better understand its relationship to the previously described variables and pain outcomes after surgery. Therefore, the purpose of this study is to better understand the factors contributing to pain in patients with chronic pelvic pain with or without endometriosis, and assess the impact of endometriosis excision surgery on pain levels.

This study is funded by the United States Association for the Study of Pain (USASP).